Membership Application | Rotary Club of Upper Kittitas County

Rotary dues are $195.00 per year for an individual membership or $260.00 per year for a business membership.

Membership Type
Membership Type*
Contact Information
Business Name*
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Primary Member Information
Name*
First Last
Title/Position*
Spouse Name
First Last
Date of Birth*
MM
DD
YYYY
Spouse Birthday
MM
DD
YYYY
Wedding Anniversary
MM
DD
YYYY
Business Information
Employment Status*
Business Name*
Title/Position*
Business Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Other Information
Sponsor's Name*
First Last
Areas where you would like to give your time and talent:*
- Community Service
- Club Social Functions
- Club Activities
Please state in your own words why you want to be a Rotarian and how you feel that you can be of service the club and the community:*
I do hereby certify that I have received a copy of the Rotary Club of Upper Kittitas County Bylaws (click here to view and download) and have read and understand them.
Signature*
Date Signed*
Month
Day
Year
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Date Submitted:
Month
Day
Year
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Date Approved:
Month
Day
Year
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Date Dues Paid:
Month
Day
Year
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Date Dues Inducted:
Month
Day
Year

Membership Type